The Renton Community Center was the setting yesterday for a public hearing on proposed rule changes to pharmacies' and pharmacists' professional responsibilities to patients. The changes were strongly supported by Planned Parenthood, NARAL, Lifelong AIDS Alliance, the Northwest Women's Law Center, and Equal Rights Washington. The room was packed.

Currently, there are no specific rules regarding pharmacists who, based on their belief system, refuse to fill a prescription. The Washington State Pharmacy Board heard citizens' comments for more than two hours.

The proposed changes to the rules would "prohibit a pharmacist from delegating the decision not to dispense a lawful prescribed drug to pharmacy support staff," and would "provide grounds for discipline when a pharmacist engages in unprofessional conduct, which includes: destroying an unfilled lawful prescription, refusing to return an unfilled lawful prescription, violating a patient's privacy, intimidating or harassing a patient, or discriminating against patients in a manner that's prohibited by state or federal law."

Those opposed to the proposed rules are in favor of adopting a "conscience clause." Such a clause would provide legal protection for pharmacists who view emergency contraception as tantamount to an abortion.

The proposed rule states that pharmacies have "a duty to deliver/distribute the prescribed drugs or provide a therapeutically equivalent drug to patients in a timely manner." The "timely manner" clause is of utmost importance if you have a prescription for HIV anti-retroviral drugs or emergency contraception (commonly referred to as "Plan B" or the "morning after pill").

Dr. Jeffrey Shouten, a medical doctor and an attorney who chairs the Governor's Advisory Council on HIV/AIDS and practices at Harborview's HIV Clinic in Seattle, says continuity in anti-retroviral treatment for HIV, and receiving the prophylaxis within 72 hours of exposure to the virus, is time sensitive and critical. He said, "I've had patients who've been discriminated against and I strongly support the proposed rules."

James B. Musslewhite, the President of Positive Voice Washington and a resident of Olympia, stood before the Board and told them that, as a man living with HIV, he believes it's really important that nothing come between the patient and the doctor regarding treatment regimens. "If you start telling pharmacists it's okay to insert your opinion, and you don't get the medicine you need, you run the risk of having the virus mutate," said Musslewhite. "The starting standard of care to suppress the virus is a three or more drug combination. The pharmacist can really damage a patient's ability to manage the virus effectively. Even though people are living longer with the virus, they're still dying every day. I had three friends die this past year."

During the first half of the hearing, the number of people testifying in support of the proposed rules was about equal to those speaking against. Some pharmacists who testified against the rule change didn't want to leave their moral views outside the door of their workplace. One young woman who identified herself as a "celibate youth" and in favor of the proposed rules, said, that "it's a pharmacist's job to dispense medication, not impose morals." Another woman, who was against the proposed rules, said the Board should "protect freedom of conscience."

Some of the most compelling testimony came from Judy Thompson from the Cedar River Clinic, who described the plight of a woman who went to fill prescriptions for antibiotics, pain killers, and a medication that helps stop bleeding after an abortion. The pharmacist said she was "morally unable" to fill the prescriptions. "This pharmacist made a moral judgment about the client, and could have placed this client's health in jeopardy. Failure to fill this prescription was potentially life threatening."

Equal Rights Washington sent out an urgent action alert to its members on Wednesday afternoon, resulting in over 752 emails supporting the proposed rules being sent to the Pharmacy Board. These emails were generated in less than 24 hours. According to ERW's Advocacy Director, Josh Friedes, the alert was the result of rumors that the religious right was going to try to pack the room.

"I'm very optimistic that the Pharmacy Board will adopt the proposed rules," said Friedes. "The LGBT community worked very well with the larger HIV/AIDS and Pro-choice communities. Working in coalition is the fastest path to full equality for Washington's LGBT individuals and families, and it is also the best way to work to create a more just society for all."